Additive Anti-inflammatory Action for Aortopathy & Arteriopathy

NCT ID: NCT04398992

Last Updated: 2026-02-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

10000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-01

Study Completion Date

2030-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Acute aortic syndrome (AAS) is a life-threatening condition. Inflammation plays a key role in the pathogenesis, development and progression of AAS, and is associated with significant mortality and morbidity. Understanding the inflammatory responses and inflammation resolutions is essential for an appropriate management of AAS.

Twenty Chinese cardiovascular centers have collaborated to create a multicenter observational registry (named Chinese registry of Additive Anti-inflammatory Action for Aortopathy \& Arteriopathy \[5A\]), with consecutive enrollment of adult patients who underwent surgery for AAS that was started on Jan 1, 2016 and will be ended on December 31, 2040. Specially, the impact of inflammation and anti-inflammatory strategies on the early and late adverse events are investigated. Primary outcomes are severe systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS), Sequential Organ Failure Assessment (SOFA) scores at 7 days following this current surgery. Secondary outcomes are SISR, 30-day mortality, operative mortality, hospital mortality, new-onset stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Aortopathy represent a major clinical challenge and are regarded as one of the leading causes of mortality among cardiovascular disorders. However, the pathological mechanisms underlying aortopathy are still far from being well understood, which makes treating this life-threatening challenging. It is increasingly clear that inflammation plays a key role in the development and progression of acute aortic syndrome (AAS) independent of cholesterol and other traditional risk factors, and characterizes both systemic and local condition.

Currently, surgery is considered the best treatment option for patients with AAS. In addition to systemic inflammatory responses triggered by AAS itself, however, procedural factors including surgical trauma, anesthesia, cardiopulmonary bypass, hypothermia, circulatory arrest, and blood transfusion as well as mechanical ventilation initiated a cascade of inflammation, which further exacerbates "inflammatory storm", and is associated with significant postoperative mortality and morbidity. Along with surgical evolutions, scientists have made new discoveries and achievements in the underlying mechanism and understanding of inflammation of AAS, which greatly encourage us to optimize treatment for these patients. Going beyond traditional surgery, anti-inflammatory action is crucially important to target the residual cardiovascular risk by specific anti-inflammatory interventions as a crucially adjunct therapeutic strategy to improve the well-being of patient.

A better understanding of the interaction between patient's inflammatory responses and anti-inflammatory strategies which may limit the residual cardiovascular risk is essential for the development of novel preventive, diagnostic, and therapeutic approaches, providing a critical pathophysiological insight into the role of inflammation in risk assessment and anti-inflammatory targeting. The epidemiological observation that biomarkers of inflammation are associated with clinical cardiovascular risk supports the theory that targeted anti-inflammatory treatment appears to be a promising strategy in reducing residual cardiovascular risk on the background of traditional surgical repair as well as basic therapy. Previous researches have shown that ulinastatin used in cardiac surgery may be effective in prevention of cardiovascular events through an anti-inflammatory effect. This residual inflammatory risk has increasingly become a viable therapeutic targeting on the background of validated surgical repair as well as basic medical therapy for AAS.

Although aortic dissection registries have been established during the last years, such as the International Registry of Acute Aortic Dissection (IRAD), the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) Registry, German Registry for Acute Aortic Dissection type A (GERAADA), the Society of Thoracic Surgeon (STS) database , and European Registry of Type A Aortic Dissection (ERTAAD), there are currently no dedicated registry to prospective collections and characteristics of inflammatory responses, anti-inflammatory strategies, and clinical outcomes especially for AAS patients. We have established a multicenter research collaboration (named "Chinese Registry of Additive Anti-inflammatory Action for Aortopathy \& Arteriopathy \[5A\]") and planned a prospectively observational study to understand the patient's inflammatory responses, characterize the potential anti-inflammatory strategies, and evaluate clinical outcome and prognosis of AAS patients at 15 years in a large study of Chinese population.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Acute Aortic Syndrome

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

observation

Data were collected by a designed form. Statistic software was used to analyze clinical data.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aged 18 years or older.
* Patients with diagnosis of AAS, including aortic dissection, penetrating aortic ulcer or intramural hematoma.
* Symptoms started within 14 days from surgery.
* Patients received medical therapy, open surgical, endovascular, or hybrid repair.
* Any other major cardiac surgical procedure concomitant with surgery for AAS, such as coronary artery bypass grafting or carotid artery replacement;

Exclusion Criteria

* Patients aged \< 18 years.
* Onset of symptoms \> 14 days from surgery.
* AAS secondary to traumatic or iatrogenic injury.
* Patients who declined participation in registration and follow-up investigation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Beijing Anzhen Hospital

OTHER

Sponsor Role collaborator

Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Hong Liu

Investigator of Department of Cardiac Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Hong-jia Zhang, MD

Role: STUDY_DIRECTOR

Beijing Anzhen Hospital

Hong Liu

Role: PRINCIPAL_INVESTIGATOR

Nanjing Medical University

Si-chong Qian

Role: PRINCIPAL_INVESTIGATOR

Beijing Anzhen Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Beijing Fuwai Hospital Chinese Academy of Medical Sciences

Beijing, Beijing Municipality, China

Site Status RECRUITING

Chongqing Hospital of Jiangsu Provincial People's Hospital

Chongqing, Chongqing Municipality, China

Site Status RECRUITING

Guangdong Provincial People's Hospital

Guangzhou, Guangdong, China

Site Status RECRUITING

The First Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi, China

Site Status RECRUITING

QianXiNan People's Hospital

Xingyi, Guizhou, China

Site Status RECRUITING

The Second Affiliated Hospital of Harbin Medical University

Harbin, Heilongjiang, China

Site Status RECRUITING

The Third Affiliated Hospital of Soochow University

Changzhou, Jiangsu, China

Site Status RECRUITING

Suqian Hospital of of Nanjing Medical University

Suqian, Jiangsu, China

Site Status RECRUITING

Dongtai People's Hospital

Yancheng, Jiangsu, China

Site Status RECRUITING

Subei People's Hospital of Jiangsu Province

Yangzhou, Jiangsu, China

Site Status RECRUITING

the Second Affiliated Hospital of Nanchang University

Nanchang, Jiangxi, China

Site Status RECRUITING

Qilu Hospital of Shandong University

Jinan, Shandong, China

Site Status RECRUITING

Shanghai DeltaHealth Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanxi Cardiovascular Hospital

Taiyuan, Shanxi, China

Site Status RECRUITING

West China Hospital of Sichuan University

Chengdu, Sichuan, China

Site Status RECRUITING

The Seventh Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, China

Site Status RECRUITING

The Friendship Hospital of Yili Kazak Autonomous Prefecture

Yining, Xinjiang, China

Site Status RECRUITING

The First Affiliated Hospital of Kunming Medical University

Kunming, Yunnan, China

Site Status RECRUITING

Zhejiang Provincial People's Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

The First Affiliated Hospital of Wenzhou Medical University

Wenzhou, Zhejiang, China

Site Status RECRUITING

Beijing Anzhen Hospital Capital Medical University

Beijing, , China

Site Status RECRUITING

Beijing Chaoyang Hospital

Beijing, , China

Site Status RECRUITING

the First Affiliated Hospital of Bengbu Medical College

Bengbu, , China

Site Status RECRUITING

Xiangya Hospital Central South University

Changsha, , China

Site Status COMPLETED

The First Affiliated Hospital of Guangzhou Medical University

Guangzhou, , China

Site Status RECRUITING

the First Affiliated Hospital of Guilin Medical College

Guilin, , China

Site Status RECRUITING

The First Affiliated Hospital of Nanjing Medical University

Nanjing, , China

Site Status RECRUITING

Nanjing First Hospital, Nanjing Medical University

Nanjing, , China

Site Status RECRUITING

the Affiliated Hospital of Qingdao University

Qingdao, , China

Site Status COMPLETED

Shanghai East Hospital Tongji University

Shanghai, , China

Site Status COMPLETED

the First Affiliated Hospital of Shantou University Medical College

Shantou, , China

Site Status RECRUITING

Teda International Cardiovascular Hospital

Tianjin, , China

Site Status RECRUITING

Tianjin Chest Hospital

Tianjin, , China

Site Status RECRUITING

Xiamen Cardiovascular Hospital

Xiamen, , China

Site Status COMPLETED

Countries

Review the countries where the study has at least one active or historical site.

China

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Hong Liu, MD

Role: CONTACT

02568303100

Hai-yang LI, MD

Role: CONTACT

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Hongwei Guo, MD

Role: primary

Xiao-tong Qi, MD

Role: primary

Xiao-kang Luo

Role: primary

02083882222

Xiao-yan Feng, MD

Role: primary

Yong Yao, MD

Role: primary

Peng-cheng Tang, MD

Role: primary

Chao ma, MD

Role: primary

Chao Ma, MD

Role: backup

Xiang Liu, MD

Role: primary

Sheng-rong Lin, MD

Role: primary

Cheng-bin Tang, MD

Role: primary

051487373012

Zhi-hua Zeng, MD

Role: primary

Zhi-hua Zeng, MD

Role: backup

Xin Zhao, MD

Role: primary

0531-82169114

Li-zhong Sun, MD

Role: primary

17314457623

Yi-fan Li, MD

Role: primary

Hong-hua Yue

Role: primary

13281130798

Xu-ran Lu

Role: primary

09914609084

Xiang-xiang Zheng, MD

Role: primary

8613851799076

Xiang-feng Bai

Role: primary

8715324888

ZHIQIANG Dong, MD

Role: primary

ZHIQIANG DONG, MD

Role: backup

ZHIWEI LI

Role: primary

ZHIWEI LI, MA

Role: backup

Si-chong Qian

Role: primary

13120130755

Lu Han, MD

Role: primary

Lu Han, MD

Role: backup

Yi-yao Jiang, MD

Role: primary

Ying-yuan Zhang, MD

Role: primary

Xing-xing Peng, MD

Role: primary

Hong Liu, MD

Role: primary

188012181613

Liang Hong, MD

Role: primary

Ying Wu, MD

Role: primary

Yu-qi Wang, MD

Role: primary

JUN-QUAN CHEN, MD

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Liu H, Li HY, Li YL, Wu Y, Gu JX, Diao YF, Shao YF, Sun LZ, Qian SC, Zhang HJ; 5A Investigators. Operative Mortality After Type A Aortic Dissection Surgery: Differences Based on Sex and Age. JACC Adv. 2024 Mar 14;3(4):100909. doi: 10.1016/j.jacadv.2024.100909. eCollection 2024 Apr.

Reference Type DERIVED
PMID: 38939657 (View on PubMed)

Liu H, Diao YF, Shao YF, Qian SC, Zeng ZH, Fan GL, Ma LY, Zhang HJ; on the behalf of the Additive Anti-inflammatory Action for Aortopathy & Arteriopathy (5A) Investigators. Prognostic implication of residual inflammatory trajectories in acute type I aortic dissection: dual-center prospective cohort study. Int J Surg. 2024 Jun 1;110(6):3346-3356. doi: 10.1097/JS9.0000000000001245.

Reference Type DERIVED
PMID: 38445499 (View on PubMed)

Liu H, Qian SC, Li HY, Shao YF, Zhang HJ; China Additive Anti-inflammatory Action for Aortopathy, Arteriopathy (5A) Investigators. Chinese Additive Anti-inflammatory Action for Aortopathy & Arteriopathy (5A) Registry protocol: rationale, design and methodology. BMC Cardiovasc Disord. 2024 Feb 21;24(1):120. doi: 10.1186/s12872-024-03760-y.

Reference Type DERIVED
PMID: 38383323 (View on PubMed)

Liu H, Sun BQ, Qian SC, Sun MY, Shao YF, Ding Y, Li H, Zhang HJ. Contemporary use and outcome of Cabrol shunt in type A aortic dissection surgery: insight from China 5A study. Open Heart. 2023 Dec 9;10(2):e002465. doi: 10.1136/openhrt-2023-002465.

Reference Type DERIVED
PMID: 38070883 (View on PubMed)

Zhao HL, Tang ZW, Diao YF, Xu XF, Qian SC, Li HY, Shao YF, Zhao S, Liu H; on the behalf of the Additive Anti-inflammatory Action for Aortopathy, Arteriopathy (5A) Investigators. Inflammatory profiles define phenotypes with clinical relevance in acute type A aortic dissection. J Cardiovasc Transl Res. 2023 Dec;16(6):1383-1391. doi: 10.1007/s12265-023-10436-z. Epub 2023 Sep 15.

Reference Type DERIVED
PMID: 37713048 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

5A-Plan

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

China Valve Registry Study-1
NCT02623907 UNKNOWN